The Federal Trade Commission is soliciting public input on the ways that practices by large, vertically integrated Pharmacy Benefit Managers’ (PBMs) are affecting drug affordability and access. The Request for Information covers a wide range of issues in the PBM market, including contract terms, rebates, fees, pricing policies, steering methods, conflicts of interest, and consolidation. The agency seeks information on these practices and their impact on patients, physicians, employers, independent and chain pharmacies, and other businesses across the distribution system.
PBMs are companies that manage prescription drug benefits on behalf of private health insurers, Medicare Part D drug plans, large employers, and other payers. The largest PBMs are vertically integrated with health insurance companies and specialty pharmacies, giving them financial incentives to steer patients to use their affiliated services. Moreover, in response to the Commission’s request for public input on contracts terms that may harm fair competition, many independent pharmacies commented that PBM contractual terms are confusing, unfair, opaque, and arbitrary.
The Request for Information will enable agency staff to study a wide array of PBM business practices and issues and will help inform the agency’s policy and enforcement work. Members of the public can comment on any issues or concerns they believe are relevant or appropriate for the agency’s consideration by submitting written data, views, facts, and opinions addressing this subject. The comment period closes Wednesday, April 25.
The Request for Information is available for public comment.